FL-117 NOTICE AND ACKNOWLEDGMENT OF RECEIPT _Family by xiagong0815

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									                                                                                                                                                       FL-117
 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):                                              FOR COURT USE ONLY


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 SUPERIOR COURT OF CALIFORNIA, COUNTY OF
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                                                                                                         CASE NUMBER:
                       NOTICE AND ACKNOWLEDGMENT OF RECEIPT

      To (name of individual being served):
                                                                                 NOTICE
    The documents identified below are being served on you by mail with this acknowledgment form. You must personally sign, or a
    person authorized by you must sign, this form to acknowledge receipt of the documents.
    If the documents described below include a summons and you fail to complete and return this acknowledgment form to the
    sender within 20 days of the date of mailing, you will be liable for the reasonable expenses incurred after that date in serving you
    or attempting to serve you with these documents by any other methods permitted by law. If you return this form to the sender,
    service of a summons is deemed complete on the date you sign the acknowledgment of receipt below. This is not an answer to
    the action. If you do not agree with what is being requested, you must submit a completed Response form to the court within 30
    calendar days.

Date of mailing:


                                   (TYPE OR PRINT NAME)                                       (SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE
                                                                                                             AND MUST BE 18 OR OLDER)

                                                             ACKNOWLEDGMENT OF RECEIPT
                                                          (To be completed by sender before mailing)
I agree I received the following:
       a.         Family Law: Petition (form FL-100), Summons (form FL-110), and blank Response (form FL-120)
        b.               Family Law—Domestic Partnership: Petition—Domestic Partnership (form FL-103), Summons (form FL-110), and
                         blank Response—Domestic Partnership (form FL-123)
        c.               Uniform Parentage: Petition to Establish Parental Relationship (form FL-200), Summons (form FL-210), and blank
                         Response to Petition to Establish Parental Relationship (form FL-220)
        d.               Custody and Support: Petition for Custody and Support of Minor Children (form FL-260), Summons (form FL-210),
                         and blank Response to Petition for Custody and Support of Minor Children (form FL-270)
        e.              (1)         Completed and blank Declaration Under          (5)        Completed and blank Financial Statement
                                    Uniform Child Custody Jurisdiction and                    (Simplified) (form FL-155)
                                    Enforcement Act (UCCJEA) (form FL-105)         (6)        Order to Show Cause (form FL-300), Application
                        (2)         Completed and blank Declaration of                        for Order and Supporting Declaration (form
                                    Disclosure (form FL-140)                                  FL-310), and blank Responsive Declaration to
                        (3)         Completed and blank Schedule of Assets                    Order to Show Cause or Notice of Motion (form
                                    and Debts (form FL-142)                                   FL-320)
                                                                                   (7)        Other (specify):
                        (4)         Completed and blank Income and
                                           Expense Declaration (form FL-150)
(To be completed by recipient)
Date this acknowledgment is signed:


                                   (TYPE OR PRINT NAME)                                          (SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)

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Form Approved for Optional Use                                                                                            Code of Civil Procedure, §§ 415.30, 417.10
  Judicial Council of California
                                                   NOTICE AND ACKNOWLEDGMENT OF RECEIPT                                                        www.courtinfo.ca.gov
 FL-117 [Rev. January 1, 2005]                                               (Family Law)

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